Warning: Be Careful When Mixing Prescriptions

Two years ago a Wisconsin man hospitalized for pneumonia was diagnosed with type 2 diabetes and prescribed 100 mg of Januvia, one of the common oral medications used for treatment. A month later, he was back in the hospital complaining about stomach pain and worried something else was wrong.

Something else was indeed wrong.

He had been taking medicine for kidney stones which produced an adverse reaction to the Januvia in his system. The hospital never checked and it wasn’t until his wife opened a letter from his pharmacist concerned when he saw the Januvia prescription while he was hospitalized the second time that everyone realized the mistake. His Januvia dosage was then decreased.

“Adverse prescription drug interactions are becoming more and more an issue,” says Barbara Young, Consumer Medication Information editor at the American Society of Health-System Pharmacists (ASHP). “The FDA and the manufacturer will look at tests between Drug A and Drug B but they don’t look at how Drug A works with five others that patient may be taking. It’s evolving, but prescription drugs still aren’t tested in big studies using age, or the speed of one’s metabolism or other clinical variables.”

While interaction warnings are included with every prescription filled at drugstores, many people tend to ignore this extra piece of paper and toss it into the trash.

A recent study by the Mayo Clinic shows 70% of Americans use one prescription drug while half the population uses two prescriptions. In 2012, the Consumer Reports National Research Center prescription drug poll revealed an average of 4.1 prescription drugs are taken by Americans while 14% take 7 or more. Add to the fact that many patients use a number of doctors who may not be communicating with each other and a prescription drug problem becomes obvious.

It’s Not Just Prescriptions

Supplements are also creating problems with prescriptions. “Supplements are an emerging problem area because people are looking for treatment without seeing a doctor and the FDA only regulates supplement products without conducting studies to show how well it works with a certain condition,” explains Barbara Young. “In addition, there’s no requirement that supplement manufacturers show potential side effects on the label. So people see the supplement on the shelf and figure it must be okay.”

While supplements are a $32 billion/year business (by contrast, prescription drugs rake in $325 billion/year) the Journal of the Academy of Nutrition and Dietetics reports that 34% of the population – about one in three – take a supplement along with prescription drugs. Mixing supplements with prescription drugs can be risky.

For instance, St John’s Wort – a common treatment for depression – is available on any drugstore shelf. However, recent studies show that its use can limit the effectiveness of some prescription drugs, including the heart medication Digoxin and birth control pills.

What to Do?

Precautions you could take are to review each prescription with your doctor and keep a list of medicines that have been prescribed by other doctors.

Also see our list of online resources in the accompanying sidebar — however, a website is never a substitute for consulting with your personal medical team.

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Online ResourcesKeep this list of websites in your wallet, and add it to your Smartphone In Case of Emergency (ICE) setting – or use one of many apps that are now available for prescription lists in the event that you end up in the hospital.

The FDA constantly updates its website using reports from medical professionals about problematic side effects of not just prescriptions, but food, medical devices and even cosmetics:http://www.fda.gov/Safety/MedWatch/default.ht

The FDA also identifies potential problems for users of supplements:http://ods.od.nih.gov/factsheets/list-all/

The National Institutes of Health (NIH) MedlinePlus website provides information about adverse effects between prescriptions, supplements as well as herbal ingredients. Just click on “Drugs & Supplements” and type in the product name. http://www.nlm.nih.gov/medlineplus/

A number of major drugstore chains provide information about potential adverse reactions between prescriptions, such as:

Rite Aid Pharmacywww.riteaid.com

CVS Pharmacyhttp://www.cvs.com/drug/information.jsp

CVS pharmacies uses a DUR (Drug Utilization Review) system that will look at a customer’s prior prescriptions and flag any new prescription being presented that may have a potential adverse reaction with existing prescriptions purchased at the pharmacy.

CVS also has a website designated for medications and supplements:http://www.cvs.com/drug/interaction-checker.jsp

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